Executive Function Survey

Pick the number which best describes you for each statement.

Name


  1. How old are you?
    10
    11
    12
    13
    14
    15
    16


  1. I can independently set goals for my grades in school.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. When plans change suddenly, I am flexible about the new thing I have to do.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I often act without thinking how things will turn out.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I usually know how long it will take to do an assignment.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. Which is your ethnic group?
    White
    Hispanic
    Black
    Asian
    Native American


  1. Its easy to find the things I need in my locker because I am organized.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I can get angry fast.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I am able to remember the things I read.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I am able to remember the information that I hear about in class.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. My friends look to me to organize fun things to do.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. If my first attempt to solve a problem fails, I usually don't know what to do next.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. When thoughts pop into my brain, like calling a kid a name or pushing someone, I act on them without thinking.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I complete my school work on time.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. My parents think I am very forgetful.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I am able to make plans for my school day.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I have a lot of control over the grades I get in my classes.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I lose a lot of assignments before I can hand them in.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I am
    male
    female


  1. I am able to remember the things that I see.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I am able to organize my school assignments and projects.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. Most of the time, I am able to look at my behavior and decide if it is OK to the situation I am in.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I often forget things like chores and homework.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. It takes me a lot longer than my friends to do schoolwork.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I can't remember things as well as my friends can.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I can usually find more than one way to solve a problem.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. It is pretty hard for me to control my behavior when my friends are acting up.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I sometimes get in trouble because I come home late because I haven't realized how much time has gone by.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I often have late assignments.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. If you looked at my room at home it would be a mess right now.
      1 2 3 4 5  
    Strongly agree   Strongly disagree